Predicting Patient No-show Behavior: a Study in a Bariatric Clinic

PurposeNo-shows of patients to their scheduled appointments have a significant impact on healthcare systems, including lower clinical efficiency and higher costs. The purpose of this study was to investigate the factors associated with patient no-shows in a bariatric surgery clinic.Materials and MethodsWe performed a retrospective study of 13,230 records for 2660 patients in a clinic located in Rio de Janeiro, Brazil, over a 17-month period (January 2015-May 2016). Logistic regression analyses were conducted to explore and model the influence of certain variables on no-show rates. This work also developed a predictive model stratified for each medical specialty.ResultsThe overall proportion of no-shows was 21.9%. According to multiple logistic regression, there is a significant association between the patient no-shows and eight variables examined. This association revealed a pattern in the increase of patient no-shows: appointment in the later hours of the day, appointments not in the summer months, post-surgery appointment, high lead time, higher no-show history, fewer numbers of previous appointments, home address 20 to 50km away from the clinic, or scheduled for another specialty other than a bariatric surgeon. Age group, forms of payment, gender, and weekday were not significant predictors. Predictive models were developed with an accuracy of 71%.ConclusionUnderstanding the characteristics of patient no-shows allows making improvements in management practice, and the predictive models can be incorporated into the clinic dynamic scheduling system, allowing the use of a new appointment policy that takes into account each patient's no-show probability.